1. Field of the Invention
The invention relates to the field of orthopedic devices, and more particularly to cervical/head support cushion and therapy devices for the head and neck.
2. Description of Related Art
Many professions require sustained cervical/neck and upper thoracic spinal flexion postures including surgeons, dentists, scientists/researchers looking into microscopes, and students. Many daily activities also require a person to be looking down for an extended period of time such as working at a computer, reading, or writing. The structures (muscles, tendons, ligaments, discs) in the cervical spine and upper thoracic spine are stressed in a sustained flexion in a flexed posture. If one is bending at the waist to look down, the neck could be in a neutral position and those structures not stressed, but that is not a practical way to look down. Also, it would be impossible to hold that position for very long, as it places too much load in the lumbar spine. To look down, it is more practical to flex one's neck, especially for extended periods of time. The upper thoracic spine follows suit with the cervical spine. Safely supporting the head while the neck is in a flexed position is critical in helping to alleviate or even prevent pain and disability, while allowing one to perform their work/activity for a longer period of time. There are many posterior neck muscles that can potentially be affected by extended periods of cervical flexion, including the longissimus capitis, longissimus cervisis, semispinalis capitis, splenius capitis, splenius cervisis, and suboccipital muscles. Excessive time spent in a flexed posture without support can also put excessive forces on the cervico-thoracic intervertebral discs, ligaments, muscles, tendons, connective tissues, and facet joint, which can lead to pain and/or injury.
Many neck cushions and braces have been made for the purpose of supporting the head and neck while the user/wearer is in a lying down or sitting up position with the head and neck in a neutral position. While they may help to unload the cervical and upper thoracic spine, they do not do so while the user is in a cervical flexion position.
A wide variety of cervical support devices are known and these devices are mostly intended for medical or therapeutic purposes. These devices are typically constructed of rigid or soft materials such as plastic or foam. The device typically rests on the shoulders, supports the neck, and holds the head and neck in a normal eyes- or face-forward anatomical position while the wearer is sitting upright or standing. These devices are not well suited for relatively unrestricted physical activities and typically prevent the user from looking downwards except with only their eyes or having to bend forward from their trunk. Other devices are intended to support the neck and head when the wearer is in a supine or side lying position. These devices are intended to provide support and proper alignment of the head-and-neck during rest or sleep.
One such device is illustrated in U.S. Pat. No. 5,738,640 to Carlson-Orsi. This device includes an upper cervical horizontal cushion, and an attached upper thoracic spine vertical cushion with straps to hold the device against the upper portion of the spine. It is intended to be used in a chair or bed with the wearer's head-and-neck resting against the chair or bed pillow. Again, this device is not intended to be used to provide neck support during physical activities or when the user has to look down. Because of, among other things, the device's top-of-shoulder-straps attachment site onto the cervical (top or horizontal) component of this device's cushions, there is no effective forward pull, and consequently, that device does not and cannot support the head and neck in flexion during downward-looking activities.
The prior art also includes numerous cervical orthoses designed to partially or totally immobilize the head and neck. Examples of such orthoses are described in U.S. Pat. No. 4,204,529 to Crochrane; U.S. Pat. No. 4,520,801 to Lerman; U.S. Pat. No. 4,712,540 to Tucker; U.S. Pat. No. 5,097,824 to Garth; U.S. Pat. No. 5,575,763 to Nagata et al. The immobilization provided by these devices result in a desired spinal alignment, reduced neck muscle strain or spasm and transfers the load of the head to the shoulder area. However, these cervical orthoses create the problem of extended immobilization weakening the muscles that stabilize the head and neck. They do not permit rotation or flexion of the head, therefore limiting the user in the activities in which they can participate. These devices do not allow the user to perform any activities that require cervical/neck flexion, and thus do not and cannot support the head and neck in flexion during downward-looking activities.
Other known cervical therapy devices, such as described in U.S. Pat. No. 5,116,359 to Moore; U.S. Pat. No. 5,320,640 to Riddle et al; U.S. Pat. No. 5,336,138 to Arijawat; U.S. Pat. No. 6,551,214 to Taimela; U.S. Pat. No. 6,599,257 to Al-Obaidi et al; and U.S. Pat. No. 6,692,451 to Splane, support the head and therapeutically exercise the neck in one or more planes. However, these cervical therapy devices are cumbersome cervical therapy devices built onto a chair or table requiring patients to visit a physical therapy facility for cervical therapy and are not portable for use during any desired activities. These devices also do not and cannot support the head and neck in flexion during downward-looking activities.
Another example of the prior art is illustrated in U.S. Pat. No. 6,458,090 to Walpin. The multi-positional support device disclosed allows for support in various fixed degrees of rotation as well as small ranges of head and neck rotation. However, this device presents the problem of allowing only small ranges of head and neck rotation insufficiently exercising atrophied neck muscles to strengthen them to safely support the load of the head and allow extensive ranges of rotation of the head. This device also does not and cannot support the head and neck in flexion during downward-looking activities.
Another example of the prior art is illustrated in U.S. Pat. No. 3,964,474 to Fox. The cervical collar here is made of plastic foam and includes a thin band of resilient plastic material biasing the foam into an annular shape terminating in opposed rear ends which may be separated to circumferentially expand the collar against the bias of the band for fitting about a patient's neck. A front central top portion of the collar includes a depression and the top surface itself is beveled and shaped in such a manner as to comfortably cradle a patient's front jaw portion and side areas of the head. An outer covering of fabric material may be applied about the collar for purposes of cleanliness and enhancement of the aesthetic appearance of the collar. This device is designed to support the user's neck in an upright position and not in a flexion position. It does not and cannot support the head and neck in flexion during downward-looking activities.
Another example of the prior art is illustrated in U.S. Pat. No. 4,232,663 to Newton. The cervical collar here is made of a pad of resilient foam material with a scalloped depressed area at the middle of the inside surface of the collar whereby a user's chin is supported in the depression and pressure on a user's throat area is relieved by the reduced thickness provided by the depression. This collar does not and cannot support the head and neck in flexion during downward-looking activities.
Another example of the prior art is illustrated in U.S. Pat. No. 4,617,691 to Monti et al. This device is a generally rectangular or other suitably shaped support pillow that is adapted to be removably secured around a user's neck. A single elongated wedge-shaped pillow segment is provided with fasteners for joining one end to the other. The wedge shape gives increased lateral support to the user's neck and head. Worn with the fasteners under the user's chin, it gives increased head and neck support whereas if it is worn with the fasteners behind the users head, it gives increased chin and head support. A three-piece version is also provided, and the various pillow segments may be of various sizes. A laminate may be applied to render the support pillow bacteria proof, flame retardant and waterproof while allowing heat and perspiration to escape. A spring-like closure version is also shown. This device is not intended to give support while the user is in a neck flexion position but more to function as a comfortable support for a head and neck to be used while sleeping or resting in a seated or vertical position. As such, this device does not and cannot support the head and neck in flexion during downward-looking activities.
Another example of the prior art is illustrated in U.S. Pat. No. 5,029,577 to Sarkozi. This is a soft neck support collar comprising two offset and attached, tubular ring elements, each element hooking together at their respective ends. Both ring elements contain a soft fill material such as nylon, cotton, polyester, acrylics, foam, foam chips, etc. The combined effect of the fill material together with the tubular configuration, enables the neck to adjust for lateral forward and backward forces during movement. The upper ring element is tapered at each end, so that when these ends are joined together, a space is formed into which the chin can fit, thereby maintaining the neck in a neutral position, and preventing hyperextension. The lower ring element is hooked together at each end, and the rings are offset to enable the lower ring to close at the back of the neck, approximately opposite from the closure of the upper ring element. Hence, the lower ring element functions as a continuous, uniform tubular-shaped ring which does not interfere with movement of the chin. Thus, in the closed configuration, the neck support collar allows for neutral positioning of the chin and neck, and restricts neck mobility. This collar also does not and cannot support the head and neck in flexion during downward-looking activities.
Another example of the prior art is illustrated in U.S. Pat. No. 5,303,890 to Carruth. This device is a chin rest that is arranged to include a housing having a top wall to include a pad member mounted therein. The housing includes first and second leg tubes mounted to opposed ends of the housing, that in turn include first and second respective extension legs that are provided with support pads to position the organization relative to an underlying support surface permitting an individual to rest the chin thereon during reading and other events when the individual is in the supine position, not a standing or seated position. This chin rest does not support or unload the neck of the user while performing activities that require cervical/neck flexion. It does not and cannot support the head and neck in flexion during downward-looking activities.
It is apparent that numerous head supports have been provided in the prior art that are adapted to be used in various contexts. However, even though these innovations may be suitable for the specific individual purposes to which they address, they would not be suitable for the purposes of the present invention as heretofore described.
Accordingly, there is a long-felt need for an adjustable device wearable during any activity that involves any prolonged or short duration cervical flexion that comfortably supports the cervical and upper thoracic spine and related soft tissue components. Such a device must comfortably transfer the load of the head to the cushion and upper chest of the patient and allow the neck muscles to be active when they need to be to rotate or extend the head. Such a device must facilitate a method of unloading the neck and its associated soft tissue and joints. The long sought-after but as yet unrealized device has to be inexpensive to manufacture, easy to use, and completely portable.